CAJ | 학술논문

目的：探讨维、汉民族冠心病患者胰岛素敏感性的异质性和多种危险因素的分布特点。方法选取2001年至2002年新疆维吾尔自治区人民医院住院的冠心病患者164例（维吾尔族50例，汉族114例）和对照组71例（维族35例，汉族36例），进行葡萄糖糖耐量试验和胰岛素释放试验，运用稳态模式法评价胰岛素敏感性（HOMA IS）。结果（1）维、汉民族冠心病患者胰岛素敏感性较对照组明显减低[维族（204.02±180.43） vs （409.14±181.06），汉族（258.09±105.66） vs（479.09±200.97），P＜0.05]；冠心病组代谢综合征患病率明显增多[维族（54.0%vs 25.7%），汉族（66.7%vs 22.7%）， P＜0.05]。糖尿病患病率明显高于对照组[维族（52.0%vs 0.0%），汉族（64.0%vs 0.0%），P＜0.01]。冠心病组1h胰岛素水平下降和2h血糖水平升高（P＜0.05）。其余各项虽有变化，但差异无统计学意义。代谢综合征患病率和胰岛素敏感性变化无论在对照组或冠心病组内维、汉民族间差异均无统计学意义。（2）维、汉民族冠心病患者存在体质量[（78.06±12.69） vs （72.32±12.03）kg]和体质量指数[BMI（27.29±3.53） vs （25.61±3.42）kg/m2]的显著差异（P＜0.01）。对照组中维、汉两个民族各种危险因素差异无统计学意义（P＞0.05）。（3）多个危险因素对冠心病危险性比较（logistic回归分析）看出，饮酒、糖尿病、高血压与冠心病正相关（P＜0.05）。高密度脂蛋白胆固醇与冠心病呈负相关（P＜0.05）。结论住院患者中维、汉民族冠心病存在较低的胰岛素敏感性和较高的代谢综合征、糖尿病患病率；维族冠心病患者肥胖显著。该地区饮酒、糖尿病、高血压是维、汉民族冠心病的危险因素。
목적：탐토유、한민족관심병환자이도소민감성적이질성화다충위험인소적분포특점。방법선취2001년지2002년신강유오이자치구인민의원주원적관심병환자164례（유오이족50례，한족114례）화대조조71례（유족35례，한족36례），진행포도당당내량시험화이도소석방시험，운용은태모식법평개이도소민감성（HOMA IS）。결과（1）유、한민족관심병환자이도소민감성교대조조명현감저[유족（204.02±180.43） vs （409.14±181.06），한족（258.09±105.66） vs（479.09±200.97），P＜0.05]；관심병조대사종합정환병솔명현증다[유족（54.0%vs 25.7%），한족（66.7%vs 22.7%）， P＜0.05]。당뇨병환병솔명현고우대조조[유족（52.0%vs 0.0%），한족（64.0%vs 0.0%），P＜0.01]。관심병조1h이도소수평하강화2h혈당수평승고（P＜0.05）。기여각항수유변화，단차이무통계학의의。대사종합정환병솔화이도소민감성변화무론재대조조혹관심병조내유、한민족간차이균무통계학의의。（2）유、한민족관심병환자존재체질량[（78.06±12.69） vs （72.32±12.03）kg]화체질량지수[BMI（27.29±3.53） vs （25.61±3.42）kg/m2]적현저차이（P＜0.01）。대조조중유、한량개민족각충위험인소차이무통계학의의（P＞0.05）。（3）다개위험인소대관심병위험성비교（logistic회귀분석）간출，음주、당뇨병、고혈압여관심병정상관（P＜0.05）。고밀도지단백담고순여관심병정부상관（P＜0.05）。결론주원환자중유、한민족관심병존재교저적이도소민감성화교고적대사종합정、당뇨병환병솔；유족관심병환자비반현저。해지구음주、당뇨병、고혈압시유、한민족관심병적위험인소。
ObjectiveTo explore theheterogeneityofinsulin sensitivity(IS)and thedistributionof cardiovascular risk factors in the races of the Uygur and Han patients with coronary heart diseases(CHD)in Urumqi.Methods A total of 164 CHD patients (50 Uygurs and 114 Hans) hospitalized in theAutonomousRegionalHospital from 2001 to2002 were recruited in this study. Another 71 healthy individuals (35 Uygurs and 36 Hans) served as normal controls.Oral glucose tolerance test (OGTT) and insulin release test were used to measuretheconcentrations of blood glucose and insulin before and after oral 75g glucose in 0, 0.5, 1, 2 and 3h.The HomeostasisModelAssessment ofInsulinSensitivity (HOMA IS) was calculated bythe HOMA model.Results TheIS was significantly lower in the CHD patients thaninthe normal controls[the Uygurs:(204.02±180.43)vs(409.14±181.06); the Hans:(258.09±105.66)vs(479.09±200.97);P<0.05]. The CHDpatients also had higher morbidities of metabolic syndrome (the Uygurs:54%vs 25.7%; the Hans: 66.7%vs 22.7%;P<0.05) and of diabetes mellitus (the Uygurs: 52.0%vs 0.0%; the Hans: 64.0%vs 0.0%, P<0.01) when compared with the normal controls. The CHDpatients had significantly decreased 1h insulin and increased 2h glucose than the normal controls (P<0.05). No significant difference was found in other indices between the CHD patients and normal controls. There was no difference in the morbidity of metabolic syndrome andIS between the 2 ethnics no matter for CHD patients or thenormal controls. Significant differences were seen in thebody mass[(78.06±12.69)vs(72.32±12.03)kg, P<0.01] and body mass index[BMI(27.29±3.53)vs (25.61±3.42)kg/m2,P<0.01] in thetwo ethnic patients with CHD. But no such difference was seen in the normal controls. Logistic regression analysis showed thatalcoholdrinking(OR=2.532), diabetes mellitus (OR=2.466), and hypertension (OR=2.355) had positive correlation with CHD (P<0.05), and high-densitylipoprotein cholesterolhad negative correlation with CHD (P<0.05).Conclusion Both Uygur and Han CHD patientsin Urumqihave lowerIS and higher morbidity of metabolic syndrome and diabetes mellitus. The Uygur CHD patientshavehigher prevalence of obesity. Alcohol drinking, diabetes mellitus, and hypertensionare risk factors of CHD in thetwo ethnics intheXinjiang Uygur Autonomous Region.